Getting Health Insurance Post-Op

sunshine86
on 8/30/09 3:24 pm
It's probably a long shot, but I figured I'd ask anyway.

Has anyone here in the Phoenix area been able to get approved for individual health insurance AFTER having your weight loss surgery?

I had my surgery about 3 weeks before I lost coverage from my parent's group plan. COBRA was $1925/month (obviously I couldn't afford that).... so I was ineligible for HIPPA portability. Consequently, I have not been able to find an insurance plan that'll touch me with a ten foot pole.

I even applied for AHCCCS out of desperation.... and was denied because I make too much money and don't have any dependents.

I was told that BCBS-AZ will take you after being 12 months post-op, as long as you've maintained a healthy weight for at least one year. So basically, it'll be probably another 18 months before I'll qualify because I have to get down to a healthy weight and maintain it for a year.

My pre-existings are all obesity-related, and slowly going away (hypertension, insulin resistance).

Any ideas? I'm pretty sure I've tried everything already.... but maybe one of you guys might know something I don't, lol.

Thanks!!!
HW: 243lbs   SW: 222lbs  CW: 198lbs GW: 140lbs
                                              I'm just a hair under 5'1.
                                     12/1/2009- Third Fill, 7cc in a 11cc band
                                     11/3/2009- Finally under 200lbs!!! YAY!!


JRinAZ
on 8/31/09 12:06 am - Layton, UT
On August 30, 2009 at 10:24 PM Pacific Time, Heidi A. wrote:
It's probably a long shot, but I figured I'd ask anyway.

Has anyone here in the Phoenix area been able to get approved for individual health insurance AFTER having your weight loss surgery?

I had my surgery about 3 weeks before I lost coverage from my parent's group plan. COBRA was $1925/month (obviously I couldn't afford that).... so I was ineligible for HIPPA portability. Consequently, I have not been able to find an insurance plan that'll touch me with a ten foot pole.

I even applied for AHCCCS out of desperation.... and was denied because I make too much money and don't have any dependents.

I was told that BCBS-AZ will take you after being 12 months post-op, as long as you've maintained a healthy weight for at least one year. So basically, it'll be probably another 18 months before I'll qualify because I have to get down to a healthy weight and maintain it for a year.

My pre-existings are all obesity-related, and slowly going away (hypertension, insulin resistance).

Any ideas? I'm pretty sure I've tried everything already.... but maybe one of you guys might know something I don't, lol.

Thanks!!!
Oooh!  I have been in your position.  I am sooooo sorry!  ....  Will Dr. Schuster still cover your adjustments for you without insurance?  Maybe the out of pocket for insulin and other meds will be less expensive in the long run than the high ended COBRA?  I'd recommend posting your insurance question on the Main Forum.  They may have zillions of insurance guru's that could recommend an individual plan.

In the meantime, practice the best preventive medicine that you possibly can on your own.  Follow the lapband rules to a T.  Eat well, move your body, drink your water, etc.  Maybe a new job for either yourself or your folks will bring better insurance bennies?  You're kind of the group of people that falls through the cracks!  Hopefully our elected folks can figure out some answers without killing us in the meantime:)

Take care of you sweetie pie!  Let us know if you're able to find out anymore, K?  In the meantime, support groups are free and are a big dose of medicine for the soul!!!

Hugggzzzz,
Joyce 
Rny 2/11/03-> ERny 12/26/07-> Duodenal Switch 5/12/2010   
     www.dsfacts.com , www.dssurgery.com , & www.duodenalswitch.com

                  

sunshine86
on 8/31/09 3:07 am
Joyce, you are too sweet. Thanks for replying!

Fortunately Dr. S does discounts for self-pay patients, so my fills (including the hospital fee) are $200. And thankfully I don't require insulin... just Metformin, which is super cheap. My blood pressure medicine is Atenolol, which is also extremely inexpensive... and Prozac is cheap, too.

I knew I was going to lose my insurance through my parents when I turned 23, so I worked with my doctor to gradually transition to inexpensive medicines that I knew I'd be able to afford.

I was able to find a "Temporary" catastrophic insurance plan that'll cover me for $100/month.... but it does not cover ANY pre-existings. It's nice to have though, because it counts as credible coverage... and if I fall off a cliff or something, I'll be able to afford the bills... LOL.

I was also able to qualify for a medical discount program... for people who make too much to qualify for AHCCCS. So my costs are relatively low.

There's just... this weird anxiety that goes along with not having good insurance. I had AMAZING insurance through my parents, they covered 100% of my surgery and all related costs. I just wish I would've done it sooner so that I would've had time to get healthy and find new insurance before I turned 23 and became ineligible! :)


HW: 243lbs   SW: 222lbs  CW: 198lbs GW: 140lbs
                                              I'm just a hair under 5'1.
                                     12/1/2009- Third Fill, 7cc in a 11cc band
                                     11/3/2009- Finally under 200lbs!!! YAY!!


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